Provider Demographics
NPI:1215170477
Name:GETTLER, DEAN TAYLOR (MD)
Entity type:Individual
Prefix:DR
First Name:DEAN
Middle Name:TAYLOR
Last Name:GETTLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1983 255TH ST
Mailing Address - Street 2:
Mailing Address - City:FORT SCOTT
Mailing Address - State:KS
Mailing Address - Zip Code:66701-1793
Mailing Address - Country:US
Mailing Address - Phone:620-857-4358
Mailing Address - Fax:
Practice Address - Street 1:1983 255TH ST
Practice Address - Street 2:
Practice Address - City:FORT SCOTT
Practice Address - State:KS
Practice Address - Zip Code:66701-1793
Practice Address - Country:US
Practice Address - Phone:620-857-4358
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-16
Last Update Date:2009-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-11223208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery